Ekstasis Peer Consultation

Ekstasis is an Ancient Greek word that means "to be or stand outside oneself"

Ekstasis is a peer consultation model for educators, brought to you by the University of Minnesota North Memorial Family Medicine Residency Program. It gets its name from the process of the presenter standing outside of the deliberations. The presenter is present and listening, but does not participate.

The model's reflective learning environment provides a venue for group building among peers, promotes a collegial atmosphere, and brings out the richness of the faculty group. It also creates opportunities for educators to build an inventory of local resources for educational activities.

Ekstasis structure and process

The Ekstasis model is structured to allow for deliberate reflection. Action steps can be kept as future faculty development activities for the group.

Group size

The structure is intended for small groups with an ideal size of five to eight participants. If there are more than eight participants, another Ekstasis group can be created. Or, the discussion can be held in a fishbowl format. It’s recommended to have peers from across various disciplines participate for an improved discussion.


1. Decide on a presenter. Then, appoint a facilitator to keep participants within the parameters of the session and a time keeper to manage time.

2. Presenter presents the case. Possible questions to answer in case presentation (5 minutes):

  • Who are major people involved?
  • What are the formal relationships? Prior interactions?
  • Where is the senior authority on the issue?
  • What has the presenter done or decided not to do so far?
  • What would success look like to the presenter?

3. Team asks fact-based questions. It's important to only ask fact-based questions in this step. Avoid problem solving (10 minutes)

4. Team does diagnostic brainstorming while presenter watches and listens. Some possible questions to ask and discuss (15 minutes):

  • What are the stakes?
  • What are the underlying or hidden issues?
  • What are the technical issues?
  • What options are off the table?
  • How has the presenter contributed to the problem?
  • What interpretations have the presenter been unwilling to consider?
  • Why is the presenter concerned about the situation?

5. Team does action steps brainstorming while presenter watches and listens. Suggested action steps* (15 minutes):

  • Doing the right thing
  • Doing the thing right
  • The right person to do it

6. Reflections by presenter (5 minutes)

*The action steps were borrowed from the article "A framework for developing excellence as a clinical educator."


Things to watch out for

The following are some of the things to be careful about when a case is being presented and discussions are being held:

  • Presenter dominates the conversation, defending and explaining
  • Presenter may hide real stakes and anxieties
  • Team jumps too quickly to solutions, especially technical solutions
  • Team may be afraid to tell the presenter “bad” news
  • Team arrives at a consensus too soon
  • Everyone wallows around in the facts

Getting started and more information